12 years old noisy resistant /S/
I have a question for you about a new student I am working with. He is a 12 year old boy, who was referred for a tongue thrust. He produced most /s, z/ sounds interdentally. He has made significant progress with his placement from working with a previous therapist. However, he continues to have a bit of a noisy /s/. While not that significant for most students, this particular guy’s dream is to be a sports broadcaster when he grows up! His father came in to see me last week and reported that the dentist says he has a tongue thrust. As a result he is impacting saliva by his molars. His father asked if I could work on this. I told him I would try! I wanted to ask you to share your thoughts. I would greatly appreciate it. This child does have a significant history of allergies – he does not snore, and has no other articulation or placement errors. His cognitive ability is high, and he is motivated to succeed. Did I leave anything out? I look forward to your response! Thanks so much!
How long has he been in braces? Did he once have a high or narrow palate? The term “tongue thrust” doesn’t really mean anything specific. Do you know what the DDS was referring to? Did you do a real thorough eval? I’m not sure what your specific question is. Was his resting tongue posture forward? Down? Against, between dentition?
Are his tonsils ok? Adenoids? History of a sucking habit?
It sounds like he is a classic case unless I’m missing some important information. I’d go into maximizing him for the Proficiency test #1 of the Myo Manual program; begin tx for /s/ thereafter; work on the suctioning sections of the program and take if from there. If you found several areas upon testing where he is having ‘typical” myo problems such as bolus control/collection; eating; drinking; resting tongue posture, etc., then he’ll need more of the program, perhaps through Phase 3. I hope I addressed some of your concerns. If I misunderstood what you are asking, please let me know….
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Robert M. Mason says:
May 21, 2010 at 8:38 pm
The report of the dentist that this 12 year old is impacting saliva at the molars is curious, and perhaps significant. I think what the dentist means is that saliva pools at the molars. This is where the ducts of the parotid salivary glands are located (above the upper molars). This could lead to the SLP’s report of a “noisy” /s/. A simple first suggestion to deal with this situation is to work to increase the number of swallows. This 12 year old may have to make a conscious effort to do this. If there is no success with this, he should be seen by an ENT specialist to evaluate parotid flow and the status of the parotid ducts. There may be a need for a medication that can control parotid output. FYI. In some individuals, some salivary glands can be tied off, or the parotid (Stensen’s) ducts can be surgically transposed posteriorly to the tonsillar fossae. This rerouting operation is called the Wilkie procedure.